| Placental enlargement in women with primary maternal cytomegalovirus infection is associated with fetal and neonatal disease. | |
MedLine Citation:
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PMID: 16983610 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Serological testing for primary maternal cytomegalovirus (CMV) infection during pregnancy is not routine, but ultrasound studies are routine. Therefore, we evaluated placental thickening in women with primary CMV infection during pregnancy. METHODS: The study included 92 women with primary CMV infection during pregnancy and 73 CMV-seropositive pregnant women without primary CMV infection. Neonatal CMV transmission was determined by CMV culture of urine samples. Thirty-two women were treated with CMV hyperimmune globulin to either prevent or treat intrauterine CMV infection. Maximal placental thickness was measured by longitudinal (nonoblique) scanning with the ultrasound beam perpendicular to the chorial dish. Programmed placental ultrasound evaluations were performed from 16 to 36 weeks of gestation. RESULTS: At each measurement between 16 and 36 weeks of gestation, women with primary CMV infection who had a fetus or newborn with CMV disease had placentas that were significantly thicker than those of women with primary CMV infection who did not have a diseased fetus or newborn (P<.0001); the latter group, in turn, had placentas that were significantly thicker than those of seropositive control subjects (P<.0001). For both women with and women without diseased fetuses or newborns, receipt of hyperimmune globulin after primary CMV infection was associated with statistically significant reductions in placental thickness (P<.001). Placental vertical thickness values, which are predictive of primary maternal infection, were observed at each measurement from 16 to 36 weeks of gestation, and cutoff values ranged from 22 mm to 35 mm, with the best sensitivity and specificity at 28 and 32 weeks of gestation. CONCLUSIONS: Primary maternal CMV infection and fetal or neonatal disease are associated with sonographically thickened placentas, which respond to administration of hyperimmune globulin. These observations suggest that many of the manifestations of fetal and neonatal disease are caused by placental insufficiency. |
Authors:
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Renato La Torre; Giovanni Nigro; Manuela Mazzocco; Al M Best; Stuart P Adler |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2006-09-06 |
Journal Detail:
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Title: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America Volume: 43 ISSN: 1537-6591 ISO Abbreviation: Clin. Infect. Dis. Publication Date: 2006 Oct |
Date Detail:
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Created Date: 2006-09-19 Completed Date: 2007-01-18 Revised Date: 2009-10-08 |
Medline Journal Info:
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Nlm Unique ID: 9203213 Medline TA: Clin Infect Dis Country: United States |
Other Details:
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Languages: eng Pagination: 994-1000 Citation Subset: IM |
Affiliation:
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Department of Gynecological Sciences, Perinatology, and Child Health, La Sapienza University, Rome, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cytomegalovirus Infections / drug therapy, ultrasonography* Female Fetal Diseases / prevention & control, virology Humans Immunoglobulins / therapeutic use Infant, Newborn Infant, Newborn, Diseases / prevention & control Infectious Disease Transmission, Vertical / prevention & control Placenta / ultrasonography, virology* Placenta Diseases / drug therapy, ultrasonography, virology* Pregnancy Pregnancy Complications, Infectious / drug therapy, ultrasonography, virology* Ultrasonography, Prenatal |
| Chemical | |
Reg. No./Substance:
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0/Immunoglobulins; 0/cytomegalovirus-specific hyperimmune globulin |
| Comments/Corrections | |
Comment In:
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Clin Infect Dis. 2006 Oct 15;43(8):1001-3
[PMID:
16983611
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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